城市孕妇对无创产前基因检测胎儿染色体异常的认知水平及接受程度调查

doi:10.13217/j.scjpm.2019.0432

摘要/Abstract

摘要： 目的了解城市孕妇对无创产前基因检测（NIPT）胎儿染色体异常的认知水平及接受程度。方法采用简单随机抽样方法对四川省攀枝花市某医院产科门诊的孕妇作为调查对象进行问卷调查,内容包括调查对象基本情况、NIPT技术相关知识及接受程度,对NIPT相关知识认知情况及接受情况的相关因素进行分析。结果本研究共对1 156名孕妇进行调查,调查对象年龄最小20岁,最大45岁,以汉族为主,占78.98%,文化程度以高中/中专为主,占52.51%。孕周以12~27周为主,占51.04%。孕次1次占39.01%,2~5次占39.97%。产次0次者占51.04%,1次者占30.36%。调查对象中NIPT高认知水平者有486人,占42.04%,愿意及已选择NIPT筛查者占48.01%。在NIPT相关知识中,NIPT、NIPT检测方法、NIPT与有创诊断区别知晓率相对较高,分别为60.73%、60.03%和58.04%,孕12周开始即可进行筛查、NIPT检测结果影响因素的知晓率相对较低,分别为30.02%和19.98%。多因素分析显示年龄越大（OR=1.303）、文化程度越高（OR=1.191）、有不良孕产史（OR=1.171）、家庭月均收入越高（OR=1.394）和NIPT认知水平高（OR=1.164）的孕妇愿意或已选择NIPT的可能性越大。结论攀枝花市孕妇对NIPT技术的认知水平并不理想,对无创产前基因检测技术的接受度不高,年龄、不良孕产史、认知水平、文化程度和家庭经济收入水平是影响该城市孕妇是否选择该技术的主要因素。

关键词: 胎儿染色体异常, 无创产前基因检测, 孕妇, 认知水平, 接受程度

Abstract: Objective Understand the level of cognition and acceptance of noninvasive prenatal genetic testing （NIPT） for fetal chromosomal abnormalities among urban pregnant women.Methods A simple random sampling method was used to conduct a questionnaire survey on the pregnant women who were admitted to the obstetrics clinic of a hospital in Panzhihua City, Sichuan Province. Contents of the questionnaire included the basic information of the subjects, their cognition and acceptance level of NIPT related knowledge. Data were analyzed using the chi-square test or multivariate logistic regression model.Results A total of 1 156 pregnant women aged 20-45 years were investigated in this study. And 78.98% of them were the Han nationality and 52.51% had the educational level at high school/secondary school. Of the participants, the gestational age was mainly from 12 to 27 weeks, accounting for 51.04%; 39.01% had one pregnancy, 39.97% had 2 to 5 times of pregnancies; 51.04% had no parity and 30.36% had 1 parity. Among all the respondents, 42.04% （486 cases） had high cognitive level of NIPT and 48.01% were willing to accept or have accepted NIPT screening. About the NIPT related knowledge, the awareness rates of NIPT, NIPT method, NIPT and invasive diagnosis were 60.73%, 60.03%, and 58.04%, respectively. The awareness rate of screening at 12 weeks of gestation and factors affecting NIPT results were 30.02% and 19.98%, respectively. Multivariate logistic regression analysis showed that the pregnant women with older age （OR=1.303）, higher educational level（OR=1.191）, history of adverse pregnancy or delivery （OR=1.171）, higher monthly household income （OR=1.394） and NIPT cognitive level were more likely to accept or have chosen NIPT.Conclusion The cognitive level of NIPT technology for urban pregnant women was not ideal and the acceptance of NIPT was not high. Age, history of adverse pregnancy or childbirth, cognitive level, educational level and family income level were the main factors influencing pregnant women to choose NIPT.

Key words: Fetal chromosomal abnormalities, Noninvasive prenatal genetic testing, Pregnant women, Cognitive level, Acceptance level

中图分类号:

R714.55

蒲星伊, 田梅, 陈远玲. 城市孕妇对无创产前基因检测胎儿染色体异常的认知水平及接受程度调查[J]. 华南预防医学, 2019, 45(5): 432-436.

PU Xing-yi, TIAN Mei, CHEN Yuan-ling. Cognitive level and acceptance of noninvasive prenatal genetic testing of fetal chromosomal abnormalities in urban pregnant women[J]. South China Journal of Preventive Medicine, 2019, 45(5): 432-436.

参考文献 16

[1]	刘俊涛. 无创产前检测国际指南与中国规范[J].中国实用妇科与产科杂志,2017,33(6):564-567.
[2]	王佳燕,陈敏,吴莉,等.无创产前基因检测双胎21、18和13-三体综合征的应用研究[J].中国实用妇科与产科杂志,2017,33(5):497-501.
[3]	许艳,李娜,明坚, 等.孕妇对无创产前筛查技术预防唐氏综合征的认知情况及支付意愿分析[J].中国妇幼保健,2017,32(12):2713-2716.
[4]	肖葛根. 孕妇对无创产前DNA检测的认知水平与社会因素分析[J]. 医学与哲学(B), 2018, 39(1):80-83.
[5]	谭虎, 邬玲仟. 无创基因检测的临床应用现状及问题[J]. 临床检验杂志, 2018, 36(11):6-9.
[6]	熊诗诣, 杨颖俊, 陈建平, 等. 35 827例单胎无创产前检测性染色体非整倍体病例的产前诊断及妊娠选择[J]. 中华围产医学杂志, 2018, 21(1):18-23.
[7]	Lo YMD,Fleming KA,Wainscoat JS.Strategies for the detection of autosomal fetal DNA sequence from maternal peripheral blood[J].Annals New York Academy Sci, 2010, 731(1):204-225.
[8]	姚静怡,崔岚,岳胜, 等.孕中期联合血清学和NIPT进行唐氏综合征筛查的回顾性分析[J].国际妇产科学杂志,2017,44(3):343-346.
[9]	张丽科,余学高,黄彬,等.胎儿染色体非整倍体无创检测在产前诊断中的应用价值[J].分子诊断与治疗杂志,2018, 54(2):96-102.
[10]	宋月华,孟梦,赵誉, 等.上海地区孕妇对无创性产前检测技术的接受程度调查[J].现代妇产科进展,2017,26(5):382-384.
[11]	窦娟,赵青.426例孕妇接受无创DNA产前检测(NIPT)的因素分析[J].中国医药指南,2017,15(17):127-128.
[12]	张劭勤,戚红,毛学群,等.541例孕妇接受无创DNA产前检测(NIPT)的因素分析[J].中国优生与遗传杂志,2015,23(6):17-18,58.
[13]	陈英苹. 高龄孕妇无创产前DNA筛查效能分析[J]. 中国妇幼保健,2019,34(3):608-611.
[14]	赵铁军,周珊,陈斌,等.酒泉地区2137例孕妇孕早、中期产前筛查及随访情况分析[J].中国优生与遗传杂志,2016,24(8):61-63,69.
[15]	翟巾帼,邓馨,郑艳芳,等.孕产妇对新型非侵入性产前检测技术的认知调查[J].中国妇幼保健,2016,31(16):3353-3354.
[16]	季修庆, 林颖, 胡平,等. 无创产前基因检测在血清学筛查结果为高风险的非高龄孕妇中的应用[J]. 临床检验杂志, 2015, 33(2):85-87.